The Controversy Over Maintenance of Certification

David W. Eisele, MD, Andelot professor of laryngology and otology and professor in and director of the department of otolaryngology–head and neck surgery at Johns Hopkins School of Medicine in Baltimore and chair of the ABOto MOC Committee, added that MOC is an entirely voluntary process, despite its value. “It isn’t a requirement to practice medicine,” he said. “In fact, even hospitals that require medical staffs to participate in MOC have mechanisms in place that allow non-board-certified physicians to have privileges.”

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The Importance of MOC

MOC allows physicians to demonstrate that they have maintained their knowledge base, learned new essential information, maintained their professional standing, and continue to improve in medical practice, said Dr. Nussenbaum, who emphasizes that ABOto is primarily responsible to the public. “For physicians, MOC reinforces their responsibility to be professional in their development and practice improvement,” Dr. Eisele said. “It can also give them confidence in their ongoing learning.”

Jo Shapiro, MD, an otolaryngology surgeon, director of the Center for Professionalism and Peer Support at Brigham and Women’s Hospital, and associate professor of otolaryngology at Harvard Medical School, both in Boston, said MOC is important because every physician should keep up to date with professional knowledge and skill sets. “MOC is one of the most important forms of professional self-regulation for physicians,” she said. “Most professions, such as teachers, Realtors, and pilots, require ongoing education.”

No physician is required to have board certification. Currently, some hospitals require physicians to participate in MOC and some don’t. In addition, some health insurers use it as a requirement to participate in their plans. “It should be the hiring institution’s prerogative to decide what qualifications they want physicians they are hiring to have,” said Dr. Shapiro, who is also the Society of University Otolaryngologists representative to the American College of Surgeons Board of Governors. “The proposed legislation would take away this prerogative.”

Specialty societies, as well as individual diplomates, should stand up for MOC because it is a core foundation to our profession. To allow state regulators, instead of hospitals, to decide proper qualifications for physicians would erode our professional self-regulation. MOC should be supported, not undermined, as a way to maintain public trust in physicians. —Jo Shapiro, MD

Prior to 2002, certificates for otolaryngology were issued for a lifetime. Physicians who received certificates before 2002 were grandfathered in and are exempt from needing MOC. “Even though I don’t have to participate in MOC, as I’m grandfathered in, I choose to do so because it is important to do so,” Dr. Shapiro said.